This was it—go time. Standing poised but slightly crouched like a football player about to spring into action, our eyes were on the clock. My hands were beginning to sweat within the latex gloves I was wearing and I nervously adjusted my face mask to bide the time.
“Okay guys, here we go,” I heard the surgeon say as my fellow ‘team mates’ stood in line behind me at the ready, and we counted down the seconds in our heads as he did so aloud in front of us. Hey, this was my first time doing something like this after all—and I couldn’t help but be a little nervous, not to mention I had only just been hired. I would NOT mess this up.
Standing at the door of the surgical suite, I looked at the patient. She had been secured upside-down on her back, and was being remarkably well-behaved—luckily for all of us, as it’s not always the case. Her enlarged abdomen had been shaved and scrubbed with antiseptic, and the orange-yellow sheen of betadine was apparent thanks to the bright overhead lights. The look on her face was curious, and not panicked in the least. The perfect patient.
“5…4…3…2…1… BEGIN!” The exact time was noted by another technician as the patient was sedated, intubated, and hooked up to an anesthesia machine—the surgical team had moved as if part of a well-choreographed dance, while the familiar beeping of the electrocardiogram machine began to echo eerily in the room like a metronome as it helped monitor her condition. Beep… beep… beep…
The surgeon’s skill was evident as within just minutes, a newborn baby puppy was tossed gently through the air, and I caught the little blob of flesh in the warm towel I held in my outstretched arms. I dashed with the precious cargo to a station that we had prepared in advance, and started cleaning mine up— followed closely by the other catchers with their own puppies in tow.
We removed each one from their amniotic sac, used a suction bulb to remove fluid from their mouths and noses to clear their upper respiratory tracts, and rubbed each one clean as the mother would, which stimulated them to breathe and cry. Although it’s no glamorous task, hearing that puppy cry is one of the most rewarding experiences in the world. Then, once the puppy was clean, dry, and stable, we each tied off our puppy’s umbilical cord with suture material, cut off the rest of the placenta, and placed the baby in a pre-warmed incubator until mom was recovered enough to take care of them.
- Radiograph image of canine fetuses in utero, courtesy of the Animal Hospital of Pasco (http://www.pascovets.com). Can you count how many puppies there are?
As you may have guessed, before I was a Science Writing student here at Hopkins, I had worked for a few years as a veterinary technician at an animal hospital back home. As a ‘vet tech,’ I was responsible for assisting the veterinarians in a similar manner to the way that nurses assist doctors in human hospitals. Since I always tell crazy animal stories to my classmates, we all thought my first post on this new blog should have something to do with animals, and perhaps one of the lesser-known procedures that are performed at an animal hospital. If you haven’t guessed by now, this is a canine or feline cesarean section.
Now many of you may scoff, thinking a c-section on animals? Well it’s actually more common than you might think. There are a number of reasons as to why it might have to be performed, such as the animal is way past her due date with no sign of parturition (birth), she is somehow too weak to give birth naturally, she is straining too much or having some kind of trouble (dystocia), the baby is stuck or improperly positioned near the birth canal (breeched), and so forth. In addition, some breeds almost always have to have cesarean sections performed because they have been bred to a point where their heads/hips are too oddly-shaped for natural birth to be possible. This is often the case with dogs that are extremely small, as well as pugs and other brachycephalic (flat-faced) dogs. It is almost impossible for bulldogs to be born naturally for this reason, and practically every pregnant female of this breed will have to have this procedure done.
I hope to never see a human doctor toss a newborn human baby to a nurse so she can catch it in a towel, but there actually is some science behind it when done with dogs and cats. After reading my first-person account, you may be slightly horrified and wonder why on earth a veterinarian would toss sweet little newborn puppies or kittens at his assistants rather than just handing them over. I spoke with Dr. Michael Petranto, a veterinarian with a special interest in animal reproduction and who is also the medical director at Twin Rivers Animal Hospital in East Windsor, New Jersey to shed some light on the subject.
He explained that the purpose of the toss/catch procedure, which is done during all veterinary c-sections, is mainly for speed. Plus, the entire surgery itself is carefully timed. “The ultimate goal,” he said, “is to resuscitate the pups or kittens as quickly as possible, get them warm and stable, and then get them nursing once mom is strong enough after surgery.” This is important because they must drink the mother’s “first milk” or colostrum, a substance rich in nutrients, proteins, and vital antibodies, which is only produced within 8 hours after birth.
The entire process can be done even faster when other technicians form an assembly-line, as opposed to the same person catching a baby, resuscitating it, and running back for another—that would take too long and some babies take longer than others to stabilize. This way the surgeon can just take each puppy or kitten and quickly toss one after another to a waiting technician who can give all their attention to the one they have.
If the mother is calm enough and behaves well, she will be prepped for surgery while she is awake. Usually for most other procedures, an animal’s surgical site is shaved and cleaned with antiseptic while they are under anesthesia in order to make it easier for the technicians, and to cause less stress for the animal. With c-sections, there is a concern for both the mother and her unborn litter, who can all be affected by the anesthetic drugs if they’re in the mother’s system for too long. The same holds true with people. Speed is the key.
The surgeon also has to remain sterile throughout the procedure. If the catchers get too close, they could run the risk of contaminating the doctor, as well as the surgical table and equipment if they were to accidentally touch anything. This could lead to the mother developing a dangerous infection. The doctor gently tosses the newborns one by one, which is only the distance of a few feet at most, in order to avoid this.
Dr. Petranto explained that in all his years of practice, he couldn’t remember a technician ever dropping a puppy or kitten during one of these procedures—they really have it down to an art. But, he said that even if one was dropped, natural birth would have been more traumatic. “Think about a Great Dane,” he said. “When a female is whelping [giving birth], those puppies are going to fall about the same distance if she happens to be standing. Plus the mothers pick them up, lick them, move them around and so forth. They get shaken up quite a bit and are pretty resilient.”
Interestingly, he also mentioned that many people ask if there is a different bond that forms between a mother and her litter after a cesarean section versus a natural birth, and the answer is that there may just be. As a matter of fact, there is a pheromone that the mother is stimulated to produce during natural birth that she does not during a c-section. Referred to as Appeasing Pheromone, it was only recently discovered within the last few years, and helps to calm the babies and reassure them. It also helps them become more confident and by so doing, encourages them to start exploring their surroundings as they get older. However, more research is needed at this point to determine if the lack of this pheromone in female animals who have had cesarean sections significantly affects their offspring in a negative way.
From what I have seen with my own eyes though, the mothers and their litters tend to turn out just fine.